Provider Demographics
NPI:1538679352
Name:ARTISAN COUNSELING
Entity Type:Organization
Organization Name:ARTISAN COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:757-876-9513
Mailing Address - Street 1:11 MOAT WALK
Mailing Address - Street 2:
Mailing Address - City:FORT MONROE
Mailing Address - State:VA
Mailing Address - Zip Code:23651-1020
Mailing Address - Country:US
Mailing Address - Phone:757-876-9513
Mailing Address - Fax:
Practice Address - Street 1:11 MOAT WALK
Practice Address - Street 2:
Practice Address - City:FORT MONROE
Practice Address - State:VA
Practice Address - Zip Code:23651-1020
Practice Address - Country:US
Practice Address - Phone:757-876-9513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005314101YM0800X
0701005314101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty